For over 4 million Americans with Alzheimer's disease and related disorders (ADRD), there is no effective therapy to interrupt or slow disease progression. Negative behaviors, apathy and sadness, communicate confusion, pain and discomfort impose tremendous burden on family and other caregivers. Our innovative "Simulated Presence" (SimPres(TM)) intervention uses selected memory clusters and a novel technology to create a personalized environment that enhances quality of life for ADRD persons, and provide family and other care providers a viable management alternative. SimPres is presented to ADRD persons via an inexpensive, personalized, interactive audiotape -- rich in selected memories and positive emotions, that contains one side of a "live" telephone conversation with a family member or surrogate. Phase I studies the feasibility of training family "callers" cost-effectively, with subjects drawn from different study sites. In Phase II, a Latin-squares cross-over design with assess the effectiveness of three treatments (family-made, staff-made and placebo tapes) to improve well-being, applied over three time periods, in three research sites (nursing facilities, assisted living, adult day health). Well-being is assessed through direct observation, video rating, and staff report of engagement, mood, agitation, compliance with personal care. Perceived benefits to family (enhanced means of communication, improved understanding of ADRD person) will also be assessed. PROPOSED COMMERCIAL APPLICATION: We believe SimPres will provide an individualized approach to improve well-being in persons with dementia. Specifically, we expect that, SimPres will (1) decrease problem behaviors; (2) lower the economic costs of care by delaying institutionalization, decreasing medication use, and decreasing nursing staff turnover; and (3) decrease burdens felt by family and staff.